Vaccines at the Heart of Hepatitis Elimination: Insights From the ESCMID Study Group for Viral Hepatitis (ESGVH)

Abstract

The global elimination of viral hepatitis by 2030 remains an ambitious goal that hinges not only on diagnostics and therapeutics but fundamentally on the strategic use and continued innovation of vaccines. The ESCMID Study Group for Viral Hepatitis (ESGVH) convened to examine the role of vaccination as the cornerstone of hepatitis prevention, from long-established immunisation programs to emerging opportunities and unmet needs. This review explores the evolving landscape of hepatitis vaccines against four major hepatotropic viruses. Hepatitis A offers a paradigm of vaccine effectiveness yet shifting epidemiological patterns and immunity gaps in transitional economies call for updated public health approaches. For hepatitis E, the availability of a safe and effective vaccine presents a critical but underutilised opportunity to prevent outbreaks and protect vulnerable populations, particularly in endemic regions and among high-risk groups. The prevention of hepatitis B relies on decades of success with universal childhood vaccination. Albeit rare, breakthrough infections require more insight into immune memory, viral variants, and strategies for the optimization of long-term protection. Finally, for hepatitis C, the absence of a vaccine underscores the biological and immunological complexities that have thus far impeded progress toward prevention, even as new technological platforms and cross-virus insights renew optimism. By integrating epidemiological, immunological, and translational perspectives, this article highlights how vaccines remain central to eliminating viral hepatitis.